Healthcare Provider Details

I. General information

NPI: 1205741204
Provider Name (Legal Business Name): LYNCARE GROUP HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 ST ANDREWS DR
DUNEDIN FL
34698-2722
US

IV. Provider business mailing address

1241 ST ANDREWS DR
DUNEDIN FL
34698-2722
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-8751
  • Fax:
Mailing address:
  • Phone: 727-734-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NHIEL DELA TORRE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 727-656-1057